To the Editor:—
The paper "Lack of Diagnostic Value of Creatine Phosphokinase Assay in Spinal Fluid" (199:750, 1967), which appears under the heading "Negative Results," contains data which are greatly at variance with our results.1 We have determined the creatine phosphokinase (CPK) activity in the cerebrospinal fluid of 100 patients with a modification of the method of Hughes.2 We found hardly any detectable enzyme in the spinal fluid of ten patients undergoing spinal anesthesia for elective surgery—nine patients had no measurable enzyme activity while the tenth had a level of 0.5 international units/ liter. There was a constant elevation of the enzyme level in 60% of patients with cerebral tumors in general. The results of our investigations agree with those of Herschkowitz and Cumings3 in that meningiomas were not associated with an elevated level of cerebrospinal fluid CPK. There was no elevation of the enzyme level
Nathan MJ. Creatine Phosphokinase in Cerebrospinal Fluid. JAMA. 1967;201(9):707–708. doi:10.1001/jama.1967.03130090071030
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